By Dr Laurent Benadiba
Vaginal rejuvenation involves improving, embellishing or repairing the genital region. Today, injections, lasers, radiofrequency, lipofilling and lifts are not only for the face, and now enable many women to preserve or even rediscover a fulfilling sex life.
Intimate aesthetic medicine:
- Hyaluronic acid (HA) injections into the genitals:
Hyaluronic acid is a real revolution in this field. Originally used in ophthalmology and aesthetic medicine, it has now found a major and highly effective indication in aesthetic and functional gynaecology. Hyaluronic acid can be used for the following indications: vaginal dryness, plumping the labia majora, accentuating the G zone (G spot)
Vaginal dryness is a frequent problem that affects many women nowadays – more than 40% of menopausal women – and makes their sex life considerably uncomfortable. Vaginal dryness does not only affect menopausal women but also those who are taking the mini pill, are pregnant or are taking certain anti-hormonal drugs (post cancer) or anti-depressants.
Vaginal dryness appears as vulvar irritation, burning or itching, particularly during sex, making it difficult or even impossible. Until recently, there were only local treatments available, which were often little or badly used by patients, who often ended up giving in and accepting this painful situation.
Hyaluronic acid injections are a new, straightforward therapeutic solution that more than 70% of users are happy with. A special hyaluronic acid (Desiral) is injected into the vaginal entrance around twice a year. Currently, the only product available for this indication is Desiral, from French laboratory Vivacy. The injection is quick and relatively pain-free. The effect is felt after a few weeks and can last several months. This innovative treatment is still relatively unsung, though more and more doctors are training in these techniques thanks to diplomas such as the DUMEG (University Diploma in Genital Aesthetic Medicine) in Créteil.
Other innovative methods can also treat vaginal dryness, such as vaginal lasers, PRP injections, LEDs and, most recently, stem cell injections (Nano fat).
Plumping the labia majora:
In some women, the labia majora are not well developed, which makes the labia minora look bigger. But in most cases, the labia majora are “emptied” of their fat either following weight loss, following pregnancy or as the woman ages (menopause). Women who want to plump up their outer lips can either undergo fat injections (lipofilling) or hyaluronic acid injections. We generally harvest 30 to 40g of fat and inject 15/20g per lip, as some of this fat will melt away (up to 50%), but you can have the injections redone after a period of time. The results are immediate and last several months, even years, if your weight does not fluctuate.
Another solution is injecting hyaluronic acid, which is usually used to fill wrinkles. The advantage is that these injections can be carried out in a doctor’s surgery under local anaesthetic. The quantity injected is generally lower than fat, between 2 and 4cc per side, as this product absorbs water and is therefore more volumising than fat. Filling the lips using hyaluronic acid makes the lips feel as supple as skin tissue, but the benefits reduce with time as the product is absorbed by the body over an average of 12 months. The injections are carried out in a doctor’s surgery under a mild local anaesthetic and only take a few minutes. You need around 2 to 3ml to plump up a labia majora. The results are immediate and last over 12 months.
Plumping the outer lips has a double effect because, as well as improving the aesthetic aspect, it also provides a physical cushion that protects the vaginal entrance and limits local irritation.
Enhancing the G spot:
The G or Grafenberg spot has been described as the female “prostate”, an erogenous zone that is linked to the arms of the clitoris. This G zone, not the G spot, measures around 2cm2 and is located on the front wall of the vaginal, on either side of the urethra (where the urine comes out). Injecting hyaluronic acid into this area increases the volume of the G zone and therefore enhances its stimulation during intercourse. As a consequence, women who have had these injections experience more vaginal orgasms.
These HA injections are performed in a doctors’ surgery, without anaesthetic and in just a few minutes. The injection is tricky and requires careful learning because you run the risk of damaging the urethra and stopping the urine from coming out, though thankfully only temporarily. Between 1 and 2ml of special hyaluronic acid is injected. The para-urethral glands are stimulated, making the area more lubricated, and increasing its volume. These injections are almost pain-free and are carried out in outpatient surgery. Once the area has been enhanced, it is easier to stimulate and any sexual problems are improved. The effect lasts between five and eight months.
Intimate surgery:
Intimate surgery enables us to correct, beautify or repair men and women’s intimate areas. Currently enjoying a surge in popularity, this type of surgery enables us to help a large number of patients to recover their self-confidence and rediscover a fulfilling sex life. We can improve the labia minora, labia majora, clitoral hood, mons Venus, hymen, vaginal slackening, etc. with short and straightforward procedures.
Labiaplasty is the most common intimate surgery procedure carried out. The operation is straightforward and carried out in outpatient surgery under local anaesthetic. It can be performed at any age, and a request by teenagers, with parental and gynaecological authorisation, is becoming more common, as is causes real physical discomfort and embarrassment. There are many techniques to reduce the labia minora. The “edge resection” technique involves removing the excess skin that hangs beneath the outer lips by cutting the edge of the lip off, as though you were “giving it a trim”, all along the length of the inner lip. This technique is straightforward and quick, but it does not preserve the normal anatomy of the lips because it cuts off their tip. In certain cases, if too much lip is removed, the inner lips are amputated, which is not what we want. The “central wedge resection” technique reduces the inner lips while preserving the shape and normal appearance of the lips, so this is the technique most commonly performed by plastic surgeons.
Vaginal lift or vaginoplasty:
A vaginoplasty is requested by patients who are suffering from vaginal slackness. Sometimes, after pregnancy, especially after having twins, the vaginal entrance is stretched and patients complain that they have lost feeling during intercourse, despite perineal rehabilitation, as the perineum has not recovered its original tonicity. This is vaginal laxity. Just like the skin, the vaginal tissue is made up of collagen fibres. During a vaginal delivery, the tissue is stretched which damages the collagen fibres and can lead to slackness (laxity), especially around the vaginal entrance. The operation aims to reduce the inner and outer diameter of the vaginal entrance and strengthen the perineum and muscles. It take around an hour and is carried out under general anaesthetic. The work is carried out on the back wall of the vagina. Other methods to treat vaginal laxity have recently become available, to avoid the need for surgery.
Radiofrequency acts upon the perineal muscles and can make a difference from the very first session. The theory lies in stimulating collagen production using radiofrequency. This method has been used on the face for several years. The treatment is carried out in a doctor’s surgery without anaesthetic, as it does not hurt. It takes around 30 minutes and requires no downtime. Finally, we can strengthen the vaginal tonicity with vaginal lasers, fat injections or hyaluronic acid injections. An appointment with a specialist doctor will enable you to choose the most suitable treatment.
Other genital surgery requests:
Reducing the clitoral hood: The clitoral hood or clitoral prepuce is a fold of skin that covers the clitoris. It can vary in thickness and can affect the clitoris’ stimulation and sensitivity. The clitoral hood can be reduced through surgery, which is most often carried out under local anaesthetic. The inner lips may be reduced at the same time, or it might be carried out on its own if the objective is to reduce the hood without completely exposing the clitoris, which would be constantly irritated in this case.
Reducing the mons Venus:
The mons Venus is a fatty mound located underneath the pubic hair. It can be prominent even in very slim women and can cause much embarrassment, especially when wearing swimwear. These patients are not necessarily overweight. The treatment is simple: it involves sucking the fat out of the area, and is generally carried out under local anaesthetic. Sometimes an excess of skin also needs removing thanks to a mini-lift of the area.
Dr Laurent Benadiba has been a trailblazer for intimate surgery for the last 14 years, and is co responsible for teaching this discipline at university, as part of a highly innovative new diploma: DUMEG (University Diploma in Genital Aesthetic Medicine).
